FDG SPECT in patients with lung masses

Area of Science:

• Nuclear Medicine
• Radiology
• Oncology

Background:

• Pulmonary masses require accurate characterization to guide patient management.
• Current imaging modalities have limitations in differentiating benign from malignant pulmonary lesions, especially smaller ones.

Purpose of the Study:

• To evaluate the utility of 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) single-photon emission CT (SPECT) in characterizing pulmonary masses.
• To compare the performance of FDG SPECT with conventional imaging techniques for pulmonary masses.

Main Methods:

• Prospective acquisition and interpretation of FDG SPECT scans in 40 patients with pulmonary masses.
• Interpreters were blinded to the final diagnosis, using CT or chest radiograph as adjuncts.

Main Results:

• FDG SPECT demonstrated high sensitivity (100%) and specificity (90%) for pulmonary masses > 2 cm.
• For lesions 1-2 cm, sensitivity was 50% and specificity 94%, with a high positive predictive value (92%).
• Good inter-reader correlation was observed (p < 0.0001).

Conclusions:

• FDG SPECT is a valuable tool for characterizing pulmonary masses > 2 cm, comparable to PET.
• For lesions ≤ 2 cm, FDG SPECT, while suboptimal, offers advantages over standard anatomic imaging.
• The high positive predictive value for small lesions suggests potential utility in specific clinical scenarios.